Otolaryngol Clin N Am

40 (2007) 1311–1322

Fellowship Training in
Otolaryngology–Head and Neck Surgery
Matthew W. Ryan, MDa,*, Felicia Johnson, MDb
a
Department of Otolaryngology, University of Texas Southwestern Medical Center,
5323 Harry Hines Boulevard, Dallas, TX 75390-9035, USA
b
Department of Otolaryngology, The University of Arkansas for Medical Sciences,
4301 W. Markham Street, Slot 543, Little Rock, AR 72205, USA

The purpose of fellowship training after completion of an otolaryngology

residency is to provide a focused, intensive, educational experience in a rec-
ognized subspecialty area [1]. There are various reasons why a graduating
resident may wish to pursue further training. People choose a fellowship
to master a content area, usually in a field that interests them and in which
they would like to focus their practice. In other instances, fellowship train-
ing may facilitate hospital credentialing to perform certain procedures that
are considered to be outside of the scope of practice of general otolaryngol-
ogy, such as cleft lip/palate repair, skull base surgery, or free-tissue trans-
fers. For some, fellowship training functions as a mechanism to achieve
a market advantage over colleagues with a general practice. Specialization
within a narrow field also may confer a perceived improvement in job secu-
rity or safety from malpractice litigation [1].
Currently, the American Academy of Otolaryngology–Head and Neck
Surgery (AAO-HNS) Web site has links to information for fellowships in
facial plastic and reconstructive surgery, head and neck oncologic surgery,
laryngology and voice disorders, otology/neurotology/skull base surgery,
pediatric otolaryngology, rhinology and sinus surgery, and sleep medicine.
Fellowship training is commonplace within otolaryngology, and the purpose
of this article is to summarize the current fellowship training opportunities
available in otolaryngology and discuss current trends and attitudes toward
subspecialization within otolaryngology–head and neck surgery.
Fellowship training in otolaryngology–head and neck surgery is a rela-
tively new phenomenon. During the1960s there were fewer than 10 fellowship

* Corresponding author.
E-mail address: matthewwryan@gmail.com (M.W. Ryan).

0030-6665/07/$ - see front matter Ó 2007 Elsevier Inc. All rights reserved.
doi:10.1016/j.otc.2007.07.009 oto.theclinics.com
1312 RYAN & JOHNSON

programs in otolaryngology; however, this number grew to approximately

25 in the 1970s, and by 1991 there were 105 fellowships listed in the American
Academy of Otolaryngology fellowship directory. This explosion in fellow-
ships was so dramatic that by 1993 151 fellowships were listed in the same
directory [1]. The reasons behind this explosion included deficiencies in the
standard otolaryngology residency, expansion of the clinical scope of practice
of otolaryngology, and socioeconomic forces that favored fellowship direc-
tors and the trained fellow. The dramatic changes taking place within fellow-
ship training were concerning to many who felt that the strength of our
specialty depended on maintaining the integrity of the general practice of
otolaryngology and the unity of the specialty.
In the early 1990s, Dr. Byron Bailey raised the issue of proliferation of fel-
lowships in a series of editorials and papers [1–3]. He recommended that steps
be taken to ensure that subspecialization within otolaryngology would be help-
ful for the specialty. In particular, he recommended that studies be undertaken
to determine the number and type of fellowships needed to meet public need.
He stressed that manpower studies and workforce optimization (oriented
toward the public welfare) should be the guiding factors in determining the
number and variety of subspecialty fellowships offered. He also called on the
specialty to establish educational standards for fellowship training, take steps
to accredit fellowships, and study the effect of fellowships on residency educa-
tion. Finally, he advised that we develop a method to certify/credential fellows
and define the content of general otolaryngology–head and neck surgery [2].
Fellowship training in otolaryngology has gone through many changes over
the last 15 years, and to varying degrees these admonitions have been heeded.

Who does a fellowship and why?

Fellowship training is important in the academic setting. Academic pro-
grams at tertiary care institutions are burdened with caring for complex, dif-
ficult cases, and a subspecialty-trained faculty is most capable of caring for
these patients. Academic departments with residency training programs also
are charged with training residents in the depth and breadth of the field of
otolaryngology–head and neck surgery. A complement of faculty trained in
the various subspecialty areas is crucial to expose otolaryngology residents
to the myriad highly specialized diagnostic and treatment strategies within
the broader field of otolaryngology. It is no surprise that a survey by Nadol
[4] of young academics in 1997 found that 71% had done a clinical fellow-
ship after residency. It should be remembered, however, that many of the
prominent fellowship mentors around the country, and those who have
pioneered many of the techniques of subspecialty otolaryngology, were
not themselves fellowship trained. So fellowship training is not a requirement
for an academic career and, in fact, general otolaryngologists within
academic faculty can serve as effective role models for most residents who
eventually enter careers in general otolaryngology.
 FELLOWSHIP TRAINING 1313

The motivations for pursuing fellowship training are many and various.
In a 1994 survey study of fellowship-trained otolaryngologists, various mo-
tivations were uncovered [5]. The primary reason for taking a fellowship was
a perceived inadequate operative case load in the subspecialty area during
residency. This was followed by a perceived need for an extra year of train-
ing to secure an academic position and a need for an extra year of training to
enhance private practice. Interestingly, 87% of respondents, all of whom
completed fellowships, felt that the number of fellowship slots should not
be increased. This study was published in 1994, and 80% of survey respon-
dents finished their fellowship since 1980, demonstrating the relative novelty
(at the time) of fellowship training. Miller [6] studied the attitudes of resi-
dents about fellowship training. In his 1994 survey study, 32% thought
that taking a fellowship would be necessary for success in their careers,
whereas 44% thought it unnecessary. He suggested that residents may
seek fellowship training because of a perceived inadequacy of their resi-
dency. Other reasons included the desire to develop a subspecialty practice,
enhance academic progression, avoid malpractice suits, gain more hospital
privileges, improve competitiveness for patients, and increase income [6].
Various benefits accrue for otolaryngologists who pursue fellowship train-
ing. Spending even a single year concentrating on one aspect of otolaryngology
with the exposure to increased numbers of higher complexity surgical cases can
be a valuable investment. Surgical expertise comes with the performance of
large numbers of specialized procedures; for some procedures this experience
is not available in residency. A broad, diverse education in otolaryngology
often does not allow a resident to perform the numbers of cases in some subspe-
cialty areas that are required to achieve a high level of expertise. There is also
the invaluable experience of learning under the guidance of fellowship mentors.
A common reason that most residents decide against fellowship training is
their desire to practice general otolaryngology and the fact that they feel
adequately trained by their residency program. This reason differs from a prev-
alent problem in the past, when most residents who went into fellowships did so
because of inadequate training and teaching. Undoubtedly, modern residency
programs are doing a better job of training residents; consequently, the motiva-
tion for additional training has shifted. We agree with Dr. Bailey [1] that ‘‘there
is no place in the fellowship world for remedial fellowships’’ and that the
purpose of fellowship training always should be to achieve a higher level of mas-
tery in a given subspecialty, for the benefit of patients and the public as a whole.
Fellowships should not make up for inadequacies within residency training but
should enrich a physician’s career, whether it be in academic or private practice.

What fellowships are available?

Currently, fellowships are available in the following subspecialties: facial
plastics, head and neck oncology, pediatric otolaryngology, otology/neuro-
tology/skull base surgery, rhinology/sinus surgery, and laryngology/voice.
1314 RYAN & JOHNSON

Otolaryngologists are also eligible to participate in the newly accredited

sleep medicine fellowships. The subspecialties of rhinology, facial plastics,
neurotology, and pediatric otolaryngology all participate in a formal match
through the San Francisco Match (SFMatch) program, whereas the pro-
grams in head and neck oncologic surgery participate in a separate match
that is sponsored by the American Head and Neck Society (AHNS). Laryn-
gology fellowships and some other nonaccredited fellowships do not partic-
ipate in a formal match. The following section details the current fellowship
training options.

Sleep medicine
Currently, more than 50 sleep medicine fellowships are available as listed
on the American Academy of Sleep Medicine Web site [7]. Of these fellow-
ships, 43 are Accreditation Council for Graduate Medical Education
(ACGME) accredited (Box 1). Sleep medicine fellowships prepare otolaryn-
gologists to provide comprehensive medical care to patients who have disor-
dered sleep. Additional education is provided in the basic sciences related to
normal sleep and sleep disorders, organ system physiology in sleep, ad-
vanced diagnostic and management skills (eg, the interpretation of polysom-
nography,) pharmacology and medical management, and the whole range of
sleep disorders (ie, insomnia, parasomnias, sleep-related movement disor-
ders, and hypersomnia). Most of these fellowships are mentored by non-oto-
laryngologists and are 1 year in duration. A fellowship in sleep medicine can
be a useful training experience for individuals who wish to focus their prac-
tice on the medical and surgical management of sleep disorders or plan to
operate a sleep laboratory.
A sleep medicine certification program was developed recently by the
American Board of Otolaryngology (ABOto) in conjunction with the Amer-
ican Board of Internal Medicine, American Board of Pediatrics, and Amer-
ican Board of Psychiatry and Neurology. For ABOto purposes, a sleep
medicine specialist is a board-certified otolaryngologist who has been pre-
pared by an ACGME-accredited sleep medicine fellowship or who meets
the alternative pathway requirements and has passed the ABOto sleep med-
icine certification examination. This special certification for sleep medicine
first became available in 2007. The alternative pathway is valid through
2011 for people without 12 months of dedicated sleep training and is based
on practice experience with sleep medicine and interpretation of polysomno-
grams or prior certification by the non–American Board of Medical Special-
ties/American Board of Sleep Medicine. More detailed information can be
found at www.aboto.org.

Neurotology
The neurotology fellowship program is the most developed subspecialty
fellowship in otolaryngology. Fellowship training in otology/neurotology
Box 1. ACGME-accredited sleep medicine fellowships
University of Florida
University of Iowa
Rush University
Beth Israel (Boston)
Hennepin County Medical Center, Minnesota
Washington University (St. Louis)
Dartmouth-Hitchcock Medical Center
Albert Einstein University
New York University
Ohio State University
Temple University
Vanderbilt University
University of Vermont
Medical College of Wisconsin
Northwestern University
University of North Carolina
Duke University
University of Louisville
Johns Hopkins University
Mayo Clinic
University of Mississippi
Seton Hall University
University of Buffalo
Case Western Reserve University
Drexel University
University of Pennsylvania
UT Southwestern University
University of Washington
University of Michigan
Long Island Jewish Hospital
University of Cincinnati
Brigham and Women’s Hospital
Wayne State University
University of Missouri
University of Nebraska
University of New Mexico
Winthrop University
Cleveland Clinic
Thomas Jefferson University
University of Pittsburgh
University of Utah
University of Wisconsin
Henry Ford Hospital
1316 RYAN & JOHNSON

spread across the United States as otolaryngologists trained by Howard

House started their own fellowships and promulgated the neurotologic tech-
niques they had learned at the House Clinic [8]. By 1990, there were
31 known neurotology programs [8]. Neurotology certainly has been the
leader among the otolaryngology subspecialties to demand accreditation
through a governing body such as the ACGME. Through a long and diffi-
cult process, leaders at the American Otologic Society, American Neuroto-
logic Society, and American Board of Otolaryngology forged a vision for
otology/neurotology as a distinct specialty in medicine. Over a period span-
ning more than a decade, these leaders navigated through uncharted waters
to achieve a series of accomplishments.
In 1992, otology/neurotology became the first American Board of Med-
ical Specialties–approved subspecialty of otolaryngology. A 2-year fellow-
ship plan with detailed curriculum and requirements was then submitted
to the ACGME and finally approved in 1995. The first training program
was approved by the ACGME in 1997. The ABOto approved a certificate
of added qualification in 2002, and the first subspecialty examination in neu-
rotology was administered by the ABOto in 2004 [8]. To obtain this certif-
icate of added qualification, an individual must complete one of the
accredited fellowship training programs or meet the criteria spelled out in
the alternative pathway. The alternate pathway to neurotology certification
will be available until 2012. It requires 7 years of clinical practice in neuro-
tology, submission of 2 years’ operative experience, and documentation of
at least ten intracranial exposures in the last 2 years.
Currently, there are 15 ACGME-accredited programs in neurotology, all
of which require 2 years of training. The Joint Residency Committee of the
American Otologic Society and American Neurotologic Society sponsors
the matching process and restricts programs listed through the SFMatch
program to approved programs. Because of the requirements of the
ACGME, the fellowship is designated as ‘‘neurotology residency’’ [9]. The
neurotology residency provides advanced education beyond that provided
in otolaryngology residency in the basic sciences related to the temporal
bone and lateral skull base, communication sciences, neurophysiology, ad-
vanced audiologic and vestibular testing, and diagnostic evaluation and
management, including advanced surgical management of diseases of the
auditory and vestibular system, temporal bone, cerebellopontine angle, lat-
eral skull base, and related structures. Of the 2-year experience, a maximum
of 6 months is dedicated to protected time for research. The neurotology res-
idencies are subject to the same strict curricular requirements that are stan-
dard in otolaryngology residency, including work hour restrictions,
a dedicated didactic program, and instruction and evaluation based on
the six competencies.
The AAO-HNS directory lists 15 otology/neurotology and 7 neurotol-
ogy/skull base fellowships (Box 2), some of which are not ACGME-
accredited fellowships. These other nonaccredited fellowships are usually
 FELLOWSHIP TRAINING 1317

Box 2. ACGME-accredited neurotology fellowships

Stanford University
University of California San Diego
University of Southern California
Jackson Memorial Hospital (Miami, FL)
University of Iowa
Northwestern University
Massachusetts Eye and Ear (Harvard)
Johns Hopkins University
Michigan Ear Institute/Wayne State University
University of Michigan
New York University
Ohio State University
Vanderbilt University
Baylor College of Medicine
University of Virginia

1 year in duration, and their quality and content are unregulated. Current
and future participants in these nonapproved fellowships are not eligible
to obtain the certificate of added qualification in neurotology unless they
also complete an ACGME-accredited neurotology residency.

Rhinology
Fellowships in rhinology provide additional training in the diagnosis and
medical and surgical management of sinonasal disease. These fellowships
have proliferated with the introduction of endoscopic sinus surgery and de-
velopment of endoscopic techniques to address pathology of the anterior
skull base. Fellowships are usually 1 year in duration, and a formal match-
ing program was initiated in 2006. Currently, no specialty organization or
accrediting body provides oversight or quality control for these fellowships.
Although the American Rhinologic Society sponsors the rhinology fellow-
ship match through the SFMatch program and provides a directory of pro-
grams, it does not monitor or certify any rhinology training program. In the
June 2007 match for rhinology, there were 18 participating programs with
18 positions offered. Further information about the rhinology match can
be found at www.american-rhinologic.org/fellowship.phtml.

Pediatric otolaryngology
Pediatric otolaryngology is a subspecialty defined by the age of the pa-
tients and the training of the physicians. Pediatric otolaryngologists are ex-
pected to have education and experience that exceeds that afforded in
1318 RYAN & JOHNSON

otolaryngology residency. Pediatric otolaryngologists manage neonates and

children with complex otolaryngologic problems who often have significant
comorbidities. ACGME-accredited fellowships must be based at tertiary
care children’s hospitals. The ACGME-approved ‘‘pediatric otolaryngology
residency’’ must provide educational experiences in the diagnosis and treat-
ment of complex congenital and acquired conditions that involve the ear,
nose, throat, head and neck, and aerodigestive tract. Additional education
is also provided in management of disorders of voice, speech, language,
and hearing. Currently, five ‘‘pediatric otolaryngology residencies’’ are
ACGME accredited, each fellowship being 2 years in duration (Box 3).
ACGME-accredited pediatric otolaryngology residencies are subject to the
same stringent educational requirements mandated of otolaryngology resi-
dency programs, including a formal curriculum, monitoring of case num-
bers, nonclinical educational experiences, work hour restrictions, and
instruction and evaluation in the six competencies. Most pediatric otolaryn-
gology fellowships are not accredited by the ACGME, however. Overall,
21 programs are listed in the American Society of Pediatric Otolaryngology
directory, and there are approximately 26 positions available per year.
Fifteen programs participated in the most recent match in May 2007. The
nonapproved fellowship programs last from 1 to 2 years [10].
The total number of pediatric otolaryngology fellowship programs and
positions has remained stable over the last decade. In a survey of fellowship
programs, Zalzal [11] reported that there were 23 programs in 1994 and
21 programs in 1995. Twenty-four fellows graduated in 1994, and 27 fellows
graduated in 1995. These numbers are roughly equivalent to current training
numbers.
The fellowship match for pediatric otolaryngology was established in
1999 and is sponsored by the Fellowship Committee of the American Soci-
ety of Pediatric Otolaryngology. The American Society of Pediatric Otolar-
yngology does not certify or monitor any of the pediatric otolaryngology
fellowships, however, so that only ACGME-approved programs are subject
to external monitoring and verification of educational standards. Because
there is no centralized application service for the pediatric otolaryngology
match, applicants should contact programs directly to learn their individual
requirements. Additional information can be found at www.aspo.us.

Box 3. ACGME-accredited pediatric otolaryngology fellowships

Baylor College of Medicine
University of Iowa
University of Cincinnati
Children’s Hospital of Philadelphia
University of Pittsburgh
 FELLOWSHIP TRAINING 1319

Facial plastic and reconstructive surgery

Fellowship training in facial plastic and reconstructive surgery affords
eligible otolaryngologists or plastic surgeons the opportunity of a 1-year
focused experience in the evaluation and medical and surgical management
of aesthetic or reconstructive problems of the face, head, and neck. These
fellowships are sponsored by the Education and Research Foundation of
American Academy of Facial Plastic and Reconstructive Surgery
(AAFPRS). These fellowships are also regulated by the Fellowship Review
Committee of the AAFPRS to ensure educational integrity of the fellow-
ships sponsored under this program. Fellowships are 1 year in duration,
and a matching program is coordinated through the SFMatch program.
Approximately 38 spots are available per year [12]. The salary range for
this type of fellowship is highly variable and ranges from a meager stipend
to a more typical resident’s salary. Individuals who complete an AAFPRS-
approved fellowship are eligible to apply through the fellowship track for
board certification by the American Board of Facial Plastic and Reconstruc-
tive Surgery.

Laryngology
Laryngology fellowships provide experience in the advanced evaluation
and medical and surgical treatment of problems related to voice, swallow-
ing, and the laryngopharyngeal complex. Currently, eight laryngology
fellowships are listed in the AAO-HNS directory. None of these fellowships
is accredited, evaluated, or approved by an external body. Most fellowships
last for periods of 1 or 2 years, with a variable research component. There is
no matching program for laryngology fellowships.

Head and neck oncology

Head and neck oncology/oncologic surgery fellowships provide advanced
training in the diagnosis and management of neoplastic disease of the head
and neck. AHNS-approved fellowships are available to candidates who are
board eligible in surgery, plastic surgery, or otolaryngology. Fellowships typ-
ically last 1 to 2 years, with a minimum of 12 months of clinical training
required. The first regulated fellowship programs were approved by the Joint
Council for Approval of Advanced Training in Head and Neck Oncologic
Surgery in 1978 [13]. Currently, these fellowships are regulated, reviewed,
and approved by the Advanced Training Council of the AHNS. These fellow-
ships are designated ‘‘AHNS Fellowships in Advanced Training in Head and
Neck Oncologic Surgery,’’ and a diploma is awarded to individuals who suc-
cessfully complete the fellowship. The AHNS fellowships should be distin-
guished from fellowships not associated with the AHNS, for which no
accreditation, external monitoring, or quality control applies. Some of the
1320 RYAN & JOHNSON

non-AHNS fellowships are dedicated to specific aspects of head and neck sur-
gery, such as skull base surgery or microvascular reconstruction.
The number of ‘‘approved’’ fellowships has remained stable over the last
decade. Close and Miller [13] reported that 21 fellowship positions were
available at 18 institutions in 1995. Those numbers are roughly comparable
to the current 28 positions at 18 programs listed on the AHNS Web site [14].
A complete listing of AHNS programs is available at www.headandneckcancer.
org, and another listing of head and neck surgery fellowships is available at
www.entlink.net/residents/education/fellowship.

Foreign medical graduates in fellowship training

Foreign medical graduates may apply to many of the available fellowship
programs described previously. The requirements of the different subspe-
cialties or individual programs vary, and interested individuals should
contact programs well in advance of anticipated training to ensure that all
requirements are met. Applicants to ACGME-approved fellowships first
should obtain Educational Commission for Foreign Medical Graduates
(ECFMG) certification; however, ECFMG sponsorship is also available
for many other types of fellowship. The following subspecialty areas are
considered nonstandard subspecialty disciplines recognized by the ABOto
for purposes of J1 visa sponsorship by the ECFMG: craniomaxillofacial, fa-
cial plastic and reconstructive surgery, head and neck surgery, head and
neck oncologic surgery, laryngology, microvascular surgery, and rhinology.

Current state of fellowship training

The total number of fellowship programs within otolaryngology has
decreased over the past decade. Currently, 108 fellowship programs are
listed in the AAO-HNS fellowship database. The overall number of pro-
grams has decreased significantly from the 151 programs listed in the data-
base in 1994 [1]. For reference, within all of otolaryngology for the year
2005–2006 there were 103 ACGME-approved otolaryngology residencies
with 1406 total positions available (at all five levels of training) [15]. Current
fellowship programs, namely in neurotology and pediatrics, have gone
through the process of strict accreditation through the ACGME. These pro-
grams are directly associated with ACGME-approved residencies and have
well-defined educational curricula and objectives that meet the ACGME’s
stringent criteria, which elevates the standards of subspecialty training
among the various programs. According to a survey in 2005 by the AAO-
HNS section for residents and fellows, 38% of respondents were pursuing
fellowship training. This number has been fairly stable over the last 7 years
with similar percentages noted in other surveys. Apparently, the interest in
fellowship training has not waned.
 FELLOWSHIP TRAINING 1321

According to recent statistics from the SFMatch program, the number of

residents applying for fellowships each year has remained fairly stable with
no identifiable trends (Table 1). The popularity of certain subspecialties has
not changed much since the early 1990s, with facial plastic surgery having
the most applicants. One area that has grown in popularity is pediatric
otolaryngology. There is a notable trend (Table 1), with more applicants
participating in the pediatric otolaryngology match in recent years. This
trend differs significantly from the early 1990s, when head and neck surgery
attracted a larger proportion of resident applicants. In the last 10 years,
however, there has been a notable decline in the number of applicants for
head and neck surgery fellowships (Fig. 1). Why this change in subspecialty
popularity? One possibility is that the length of the training program deter-
mines its popularity. One-year fellowships may be more attractive than
2-year fellowships. Another factor determining subspecialty popularity
may relate to changing reimbursements in otolaryngology. Graduates may
be seeking subspecialty training in areas with anticipated growth in demand
for subspecialty expertise, or they may have an expectation of greater finan-
cial rewards in certain fields.
The decline in overall fellowship program numbers within otolaryngol-
ogy is probably a positive development. There are potentially negative con-
sequences if we splinter the attractive diversity of our specialty with
excessive subspecialization. The breadth of otolaryngology practice is, after
all, one of the most attractive aspects cited by medical students interviewing
for otolaryngology residency. The decline in overall fellowship program
numbers also is a reflection of the increasing regulation and standardization
of fellowship training. This regulation of fellowship programs is beneficial
because it elevates educational standards and ensures a level of consistency
in training among the various programs. It is hoped that this trend will con-
tinue, with other subspecialty organizations taking a leadership role in rais-
ing the educational standards of subspecialty fellowship.
Fellowship training beyond otolaryngology residency can be a valuable
career decision for individuals interested in focusing their practice in a nar-
rower area of otolaryngology–head and neck surgery. Although there is still
uncertainty about the appropriate number of subspecialists within otolaryn-
gology, organized otolaryngology has responded to the alarm sounded by
Dr. Bailey more than a decade ago. In conjunction with the increased op-
tions for fellowship training, there has been an improvement in the

Table 1
Resident applicants participating in a fellowship match
2002 2003 2004 2005 2006
Pediatrics 17 11 17 23 29
Facial plastics 53 53 40 46 46
Neurotology 7 19 14 22 14
1322 RYAN & JOHNSON

Fig. 1. Numbers of applicants for head and neck surgery fellowship match. (From Medina JE.
Tragic optimism vs learning on the verge of more change and great advances: presidential ad-
dress, American Head and Neck Society. Arch Otolaryngol Head Neck Surg 2001;127:751; with
permission.)

regulation and standardization of fellowship training. Subspecialties that

are most successful in raising standards for education are also the most
likely to thrive in the future.

References
[1] Bailey BJ. Fellowship proliferation: impact and long-range implications. Arch Otolaryngol
Head Neck Surg 1994;120:1065–70.
[2] Bailey BJ. Fellowship proliferation. Part I: impact and long-range trends. Arch Otolaryngol
Head Neck Surg 1991;117:147–8.
[3] Bailey BJ. Fellowship proliferation. Part II: impact and long-range trends. Arch Otolaryngol
Head Neck Surg 1991;117:265–6.
[4] Nadol JB. Training the physician-scholar in otolaryngology-head and neck surgery. Otolar-
yngol Head Neck Surg 1999;121:214–9.
[5] Crumley RL. Survey of postgraduate fellows in otolaryngology-head and neck surgery. Arch
Otolaryngol Head Neck Surg 1994;120:1074–9.
[6] Miller RH. Otolaryngology residency and fellowship training: the resident’s perspective.
Arch Otolaryngol Head Neck Surg 1994;120:1057–61.
[7] Available at: http://www.aasmnet.org/FellowshipTraining.aspx. Accessed July 2, 2007.
[8] Gantz BJ. Fellowship training in neurotology. Otol Neurotol 2002;23(5):623–6.
[9] Available at: www.sfmatch.org/residency/neurotology/index. Accessed July 2, 2007.
[10] Available at: www.aspo.us/information.php?info-1d¼14. Accessed July 2, 2007.
[11] Zalzal GH. Projected societal needs in pediatric otolaryngology. Laryngoscope 1996;106(9):
1176–9.
[12] Available at: www.aafprs.org. Accessed July 2, 2007.
[13] Close LG, Miller RH. Head and neck surgery workforce in the year 2014. Laryngoscope
1995;105:1081–5.
[14] Available at: www.headandneckcancer.org/residentfellow/fellowships.php. Accessed July 2,
2007.
[15] Available at: www.acgme.org. Accessed July 2, 2007.